Jennifer L Bailit1, Thomas E Love, Neal V Dawson. 1. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH, USA.
Abstract
OBJECTIVE: The purpose of this study was to examine the association between risk-adjusted primary cesarean delivery rates and maternal and neonatal outcomes. STUDY DESIGN: California birth certificate data that were linked to hospital discharge data for 2001 were used to create a primary cesarean delivery rate risk-adjustment model. Two hundred eighty-five hospitals were divided into 3 groups that were above, below, or within expected rate confidence intervals. Maternal and neonatal outcomes were compared within each of the 3 hospital groupings. RESULTS: Of the 285 hospitals, 27% had primary cesarean delivery rates that were above expected confidence intervals; 34% had primary cesarean delivery rates that were below expected confidence intervals, and 39% had primary cesarean delivery rates that were within expected confidence intervals. Neonatal asphyxia rates were higher in hospitals that had lower than expected rates of cesarean deliveries (0.05%, 0.1%, 0.07% for above, below, and within the confidence intervals, respectively; P < .0001). Maternal infection rates (2.1%, 2.3%, 1.8%, respectively; P < .0001) and third-degree tears (2.3%, 3.0%, 2.6%, respectively; P < .0001) were also higher in hospitals for which the cesarean delivery rates were above or below the expected rates. CONCLUSION: Risk-adjusted primary cesarean delivery rates are a good marker for maternal and neonatal outcomes.
OBJECTIVE: The purpose of this study was to examine the association between risk-adjusted primary cesarean delivery rates and maternal and neonatal outcomes. STUDY DESIGN: California birth certificate data that were linked to hospital discharge data for 2001 were used to create a primary cesarean delivery rate risk-adjustment model. Two hundred eighty-five hospitals were divided into 3 groups that were above, below, or within expected rate confidence intervals. Maternal and neonatal outcomes were compared within each of the 3 hospital groupings. RESULTS: Of the 285 hospitals, 27% had primary cesarean delivery rates that were above expected confidence intervals; 34% had primary cesarean delivery rates that were below expected confidence intervals, and 39% had primary cesarean delivery rates that were within expected confidence intervals. Neonatal asphyxia rates were higher in hospitals that had lower than expected rates of cesarean deliveries (0.05%, 0.1%, 0.07% for above, below, and within the confidence intervals, respectively; P < .0001). Maternal infection rates (2.1%, 2.3%, 1.8%, respectively; P < .0001) and third-degree tears (2.3%, 3.0%, 2.6%, respectively; P < .0001) were also higher in hospitals for which the cesarean delivery rates were above or below the expected rates. CONCLUSION: Risk-adjusted primary cesarean delivery rates are a good marker for maternal and neonatal outcomes.
Authors: Gianpaolo Maso; Monica Piccoli; Marcella Montico; Lorenzo Monasta; Luca Ronfani; Sara Parolin; Carmine Gigli; Daniele Domini; Claudio Fiscella; Sara Casarsa; Carlo Zompicchiatti; Michela De Agostini; Attilio D'Atri; Raffaela Mugittu; Santo La Valle; Cristina Di Leonardo; Valter Adamo; Mara Fracas; Giovanni Del Frate; Monica Olivuzzi; Silvio Giove; Maria Parente; Daniele Bassini; Simona Melazzini; Secondo Guaschino; Caterina Businelli; Franco G Toffoletti; Diego Marchesoni; Alberto Rossi; Sergio Demarini; Laura Travan; Giorgio Simon; Sandro Zicari; Giorgio Tamburlini; Salvatore Alberico Journal: Biomed Res Int Date: 2013-06-25 Impact factor: 3.411
Authors: Francesca L Cavallaro; Charles P Kabore; Rachel Pearson; Ruth M Blackburn; Soha Sobhy; Ana Pilar Betran; Carine Ronsmans; Alexandre Dumont Journal: BMJ Open Date: 2022-10-06 Impact factor: 3.006
Authors: Gianpaolo Maso; Salvatore Alberico; Lorenzo Monasta; Luca Ronfani; Marcella Montico; Caterina Businelli; Valentina Soini; Monica Piccoli; Carmine Gigli; Daniele Domini; Claudio Fiscella; Sara Casarsa; Carlo Zompicchiatti; Michela De Agostinis; Attilio D'Atri; Raffaela Mugittu; Santo La Valle; Cristina Di Leonardo; Valter Adamo; Silvia Smiroldo; Giovanni Del Frate; Monica Olivuzzi; Silvio Giove; Maria Parente; Daniele Bassini; Simona Melazzini; Secondo Guaschino; Francesco De Seta; Sergio Demarini; Laura Travan; Diego Marchesoni; Alberto Rossi; Giorgio Simon; Sandro Zicari; Giorgio Tamburlini Journal: PLoS One Date: 2013-06-05 Impact factor: 3.240
Authors: Hadiza Galadanci; Deepa Dongarwar; Wolfgang Künzel; Oladapo Shittu; Murtala Yusuf; Sadiq Abdurrahman; Dolapo Lufadeju; Hamisu M Salihu Journal: Int J MCH AIDS Date: 2020-03-06